Project Summary: There is a need for high-quality, population-based data on unmet need and severity of need for care, prevention, and support services on the local level to assist local planning groups (i.e. Community Planning Groups and local planning councils) in determining local allocation of CDC andiRyan White CARE Act funds. We will identify and interview recently diagnosed persons with HIV without vidence of medical care. From the interview data, insights into the factors that act as barriers for HIV infected patients in access to care or result in a delay into the care system, can serve as a basis for improved service delivery. Knowledge of the important behavioral determinants that impact morbidity will also allow for more effective allocation of resourcesto areas that may presently not be adequately addressed. These include case management, devices for improving treatment adherence and drug treatment programs. Determining factors related to not receiving care will be important in designing effective interventions for linking persons to care. Blood specimens will be collected from subjects who consent for CD4 count, HIV viral load and resistance testing. From the laboratory data that is collected for those that consent, we can determine the extent of medical services and resources that will be needed for persons who are infected with HIV, but who have not received medical care. Relevance: The purpose of this program is to develop a supplemental HIV/AIDS surveillance system to identify persons who have a diagnosis of HIV infection and who are not receiving care. The collected data will be used to determine the potential added resources that will be required when this population is linked to care. Measurable outcomes of the programwill be in alignment with the following goals for the National Center for HIV, STD and TB Prevention (NCHSTP): 1) By 2010, increase to at least 80 percent the proportion of HIV-infected people who are linked to appropriate prevention, care, and treatment services, as measured by those who report having received some form of medical care within three months of their HIV diagnosis; 2) Strengthen the capacity nationwide to monitor the epidemic, develop and implement effective HIV prevention interventions and evaluate prevention programs.